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Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum

BACKGROUND: School-based social and emotional learning interventions can improve wellbeing and educational attainment in childhood. However, there is no evidence on their effects on health-related quality of life (HRQoL) or on their cost effectiveness. OBJECTIVE: Our objective was to evaluate the co...

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Autores principales: Turner, Alex J., Sutton, Matt, Harrison, Mark, Hennessey, Alexandra, Humphrey, Neil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085485/
https://www.ncbi.nlm.nih.gov/pubmed/31347016
http://dx.doi.org/10.1007/s40258-019-00498-z
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author Turner, Alex J.
Sutton, Matt
Harrison, Mark
Hennessey, Alexandra
Humphrey, Neil
author_facet Turner, Alex J.
Sutton, Matt
Harrison, Mark
Hennessey, Alexandra
Humphrey, Neil
author_sort Turner, Alex J.
collection PubMed
description BACKGROUND: School-based social and emotional learning interventions can improve wellbeing and educational attainment in childhood. However, there is no evidence on their effects on health-related quality of life (HRQoL) or on their cost effectiveness. OBJECTIVE: Our objective was to evaluate the cost effectiveness of the Promoting Alternative Thinking Strategies (PATHS) curriculum. METHODS: A prospective economic evaluation was conducted alongside a cluster-randomised controlled trial of the PATHS curriculum implemented in the Greater Manchester area of England. In total, 23 schools (n = 2676 children) were randomised to receive PATHS, and 22 schools (n = 2542 children) were randomised to continue with usual practice. A UK health service perspective and a 2-year time horizon were used. HRQoL data were collected prospectively from all children in the trial via the Child Health Utility Nine-Dimension questionnaire. Micro-costing was undertaken to estimate the intervention costs. Missing data were imputed using multiple imputation. RESULTS: The mean incremental cost of the PATHS curriculum compared with usual practice was £32.01 per child, and mean incremental quality-adjusted life-years (QALYs) were positive (0.0019; 95% confidence interval [CI] 0.0009–0.0029). Assuming a willingness-to-pay threshold of £20,000 per QALY, the expected incremental net benefit of introducing the PATHS curriculum was £5.56 per child (95% CI − 14.68 to 25.81), and the probability of cost effectiveness was 84%. However, this probability fell to 0% when intervention costs included teacher’s salary costs. CONCLUSION: The PATHS curriculum has the potential to be cost effective at standard UK willingness-to-pay thresholds. However, the sensitivity of the cost-effectiveness estimates to key assumptions means decision makers should seek further information before allocating scarce public resources. TRIAL REGISTRATION NUMBER: ISRCTN85087674. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40258-019-00498-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-70854852020-03-23 Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum Turner, Alex J. Sutton, Matt Harrison, Mark Hennessey, Alexandra Humphrey, Neil Appl Health Econ Health Policy Original Research Article BACKGROUND: School-based social and emotional learning interventions can improve wellbeing and educational attainment in childhood. However, there is no evidence on their effects on health-related quality of life (HRQoL) or on their cost effectiveness. OBJECTIVE: Our objective was to evaluate the cost effectiveness of the Promoting Alternative Thinking Strategies (PATHS) curriculum. METHODS: A prospective economic evaluation was conducted alongside a cluster-randomised controlled trial of the PATHS curriculum implemented in the Greater Manchester area of England. In total, 23 schools (n = 2676 children) were randomised to receive PATHS, and 22 schools (n = 2542 children) were randomised to continue with usual practice. A UK health service perspective and a 2-year time horizon were used. HRQoL data were collected prospectively from all children in the trial via the Child Health Utility Nine-Dimension questionnaire. Micro-costing was undertaken to estimate the intervention costs. Missing data were imputed using multiple imputation. RESULTS: The mean incremental cost of the PATHS curriculum compared with usual practice was £32.01 per child, and mean incremental quality-adjusted life-years (QALYs) were positive (0.0019; 95% confidence interval [CI] 0.0009–0.0029). Assuming a willingness-to-pay threshold of £20,000 per QALY, the expected incremental net benefit of introducing the PATHS curriculum was £5.56 per child (95% CI − 14.68 to 25.81), and the probability of cost effectiveness was 84%. However, this probability fell to 0% when intervention costs included teacher’s salary costs. CONCLUSION: The PATHS curriculum has the potential to be cost effective at standard UK willingness-to-pay thresholds. However, the sensitivity of the cost-effectiveness estimates to key assumptions means decision makers should seek further information before allocating scarce public resources. TRIAL REGISTRATION NUMBER: ISRCTN85087674. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40258-019-00498-z) contains supplementary material, which is available to authorized users. Springer International Publishing 2019-07-26 2020 /pmc/articles/PMC7085485/ /pubmed/31347016 http://dx.doi.org/10.1007/s40258-019-00498-z Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research Article
Turner, Alex J.
Sutton, Matt
Harrison, Mark
Hennessey, Alexandra
Humphrey, Neil
Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum
title Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum
title_full Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum
title_fullStr Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum
title_full_unstemmed Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum
title_short Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum
title_sort cost-effectiveness of a school-based social and emotional learning intervention: evidence from a cluster-randomised controlled trial of the promoting alternative thinking strategies curriculum
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085485/
https://www.ncbi.nlm.nih.gov/pubmed/31347016
http://dx.doi.org/10.1007/s40258-019-00498-z
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